Feb. 20, 2006 -- A widely prescribed asthma and allergy drug proved to be no
more effective for treating hay fever symptoms than a much cheaper
over-the-counter decongestant in a newly reported study.
Hay fever sufferers in the study who took the over-the-counter drug Sudafed
24 Hour (pseudoephedrine) also experienced no more sleep problems or other side
effects than people who took the prescription drug Singulair.
That came as a big surprise to the researchers, who expected to see more
restlessness and insomnia among the pseudoephedrine users.
"It may be that sleep problems weren't an issue because the people in
the study took the once-a-day dose (240 milligrams) of pseudoephedrine in the
morning," study co-author Robert M. Naclerio, MD, tells WebMD. "[Hay
fever] symptoms also improved, and this was likely to have a positive effect on
40 Million Sufferers
More than 40 million Americans suffer from seasonal hay fever, known
medically as allergic rhinitis.
In the head-to-head comparison, Sudafed 24 Hour and Singulair proved equally
effective for treating the most common hay fever symptoms, such as sneezing,
nasal congestion, runny nose, and nose and throat itchiness.
The University of Chicago study included 30 hay fever sufferers who took
10-milligram doses of montelukast (Singulair) each morning for two weeks and 28
who took the once-a-day, 240-milligram dosage of pseudoephedrine. The study was
financed by Singulair manufacturer Merck & Co. Inc. Merck is a WebMD
Time-released 240-milligram capsules of pseudoephedrine cost about 80 cents
a day on line, compared with nearly $3 for 10 milligrams of Singulair.
"Our hypothesis was that montelukast would have additional benefits and
pseudoephedrine would interfere with sleep, but when we compared them
head-to-head we found that for the treatment of allergic rhinitis, these drugs
were virtually identical," says researcher Fuad M. Baroody, MD.
The over-the-counter pseudoephedrine actually proved to be slightly more
effective for reducing nasal congestion than Singulair, the researchers
The study is published in the February issue of the Archives of
Otolaryngology - Head and Neck Surgery.
Not First-Line Drugs
But neither of the drugs are the most widely recommended treatments for
seasonal allergies, says asthma and allergy specialist Philip E. Gallagher,
He notes that nasal steroid sprays, like Flonase, Nasacort, and Rhinocort,
are considered the first-line prescription drugs for the treatment of hay
fever. And the nonsedating antihistamine loratadine (Claritin) is considered
the first-line, over-the-counter allergy treatment.
Gallagher is a private practice allergist in Erie, Pa., and is a spokesman
for the American Academy of Allergy, Asthma, and Immunology.
He says the University of Chicago study shows that an over-the-counter drug
can work just as well as a prescription medication for many people with
"People who have mild, intermittent symptoms don't necessarily need to
run to their doctors," he says. "The over-the-counter drugs can be very
SOURCES: Mucha, S.M. Archives of Otolaryngology - Head
and Neck Surgery, February 2006; vol 132: pp 164-172. Robert M. Naclerio,
MD, professor of surgery; chief of otolaryngology, head, and neck surgery, The
Pritzker School of Medicine, University of Chicago. Fuad M. Baroody, MD,
University of Chicago. Philip E. Gallagher, MD, Allergy and Asthma Associates
of NW Pennsylvania, Erie, Pa; spokesman, American Academy of Allergy, Asthma,